1699727131 NPI number — MS. SHERRA ROGERS ARNP

Table of content: MS. SHERRA ROGERS ARNP (NPI 1699727131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699727131 NPI number — MS. SHERRA ROGERS ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROGERS
Provider First Name:
SHERRA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699727131
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 SPRING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JEFFERSONVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47130-3554
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-282-1888
Provider Business Mailing Address Fax Number:
812-218-9318

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 SPRING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JEFFERSONVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47130-3554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-282-1888
Provider Business Practice Location Address Fax Number:
812-218-9318
Provider Enumeration Date:
05/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  3016P , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 3003016 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1487872636 . This is a "ARNP NPI GROUP #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000704589 . This is a "ANTHEM #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7100155400 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: CK2274 . This is a "RR MEDICARE GROUP NUMBER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: P00931912 . This is a "RR MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1063415297 . This is a "PV GROUP MD NPI" identifier . This identifiers is of the category "OTHER".




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